The evolution of culture and cohesion in the group treatment of ego impaired children.
The challenge of group treatment with ego impaired children is to provide a situation in which their maladaptive efforts to organize volatile affects and impulses can be tolerated and structured. This article addresses the process of culture building in group and how it can provide a cohesive structure for affective expression that is acceptable and tolerable to the defensive, resistant child. In particular, the author will argue that it is through the sense of normality and commonality engendered by indigenous peer culture that the members initially develop a structure and language for affiliation, play, and mutual identification. By facilitating the cohesion of indigenous peer culture, the therapist creates a sufficient holding environment to begin a dialogue involving both verbal and nonverbal communication. For children who are difficult to engage in discussion, let alone treatment, this dialogue is the essential process for creating a corrective emotional experience. Through a concise case study, the author describes the process by which the children's efforts to express and create their own culture are cultivated, managed, and understood.